探讨腹腔镜胆总管结石取石术联合免T管一期缝合术的临床疗效。

回顾性分析2015年1月至2016年12月期间84例胆总管结石患者资料，根据治疗术式分为T管引流组(41例)和免T管一期缝合组(43例)。T管引流组采用腹腔镜微创取石术联合T管引流术治疗，免T管一期缝合组采用腹腔镜微创取石术联合免T管一期缝合术治疗。采用SPSS 17.0统计学软件进行分析，术中与术后恢复指标及术后生活质量GIQLI评分等计量资料用(±s)的形式表示，采用独立t检验；并发症比较采用χ²检验比较；P<0.05为差异有统计学意义。

免T管一期缝合组患者手术时间、术后留引流管时间、术后住院时间均低于T管引流组(P<0.05)；术后，免T管一期缝合组患者术后并发症总发生率2.3%，低于T管引流组的14.6%，差异有统计学意义(P<0.05)；术后3个月两组患者的生活质量GIQLI评分均高于术前，且免T管一期缝合组高于T管引流组(P<0.05)。

腹腔镜胆总管结石取石术联合免T管一期缝合术的手术时间和术后住院时间短，并能有效缩短患者术后引流管留置时间，促进患者胃肠功能恢复，降低并发症发生率，改善患者术后生活质量，具有较高的临床应用价值。

To investigate the clinical effect of laparoscopic choledocholithotomy combined with T-tube-free primary suture.

84 cases of congenital choledocholithiasis treated in our hospital from January 2015 to December 2016 were selectedand analyzed. All the patients were divided into T tube drainage group and T-tube-free primary suture group according to the therapeutic procedure. 41 patients in T tube drainage group were received laparoscopic minimally invasive lithotomy combined with T-tube drainage, while 43 patients in T-tube-free primary suture group were treated with laparoscopic minimally invasive lithotomy combined with T tube-free suture. Statistical analysis were performed by using SPSS17.0, clinical data of intraoperative and postoperative recovery and GIQLI score were presented as (±s) and compared by t test; Complications were compared by chi square test. A P value of <0.05 was considered as significant difference.

The operation time, indwelling time of drainage tube, postoperative hospital stay in T-tube-free primary suture group patients were significantly lower than those in T tube drainage group (P<0.05). The overall incidence of biliary tract hemorrhage, infection and stenosis in T-tube-free primary suture group was 2.3%, which was significantly lower than that in T tube drainage group of 14.6% (P<0.05). At 3 months after operation, the GIQLI scores of both groups were significantly higher than preoperative GIQLI scores, and the GIQLI scores of T-tube-free primary suture group was significantly higher than that of T tube drainage group (P<0.05).

Laparoscopic choledocholithotomy combined with T-tube-free primary suture has significant curative effect, shorter operative time, shorter postoperative hospital stay, shorter postoperative drainage tube indwelling time, which can promote patients Gastrointestinal function recovery, decrease the complication rates, improve patient quality of life after surgery, has higher clinical value.